How Does Assisted Living Work Financially

Alex Senior Living provides affordable assisted living.  For more information please call Alex Senior Living at (815) 534-5389 if you need a financial Assisted Living Facility.

The majority of assisted living communities provide both all-inclusive and fee-for-service rates. All-inclusive means that a single monthly charge covers rent, meals, and any optional services such as housekeeping or transportation selected by the renter. Residents pay only for the services they utilize under a fee-for-service arrangement.

Financial assisted living

Typically, the all-inclusive model is less expensive if a resident plans to use the full range of services an assisted living community offers. Suppose a resident will only require a limited number of services or rely on outside assistance for a limited number of benefits. In that case, the fee-for-service model will result in more significant cost savings.

The predicted average monthly cost of assisted living in the United States in 2019 is $4,000. Alzheimer’s and dementia care in assisted living (referred to as Memory Care) costs an additional $800–1,200 per month on average, for a total of $4,800–5,200 per month. The cost of assisted living varies significantly by state. Monthly expenditures in the South and Midwest range from $2,800 and $4,600. On the West Coast and in the Northeast, monthly rents range between $4,200 and $6,050.

Assistance with the Cost of Assisted Living

Medicaid and Long-Term Care

It provides financial help for assisted living through a variety of different Medicaid programs. Medicaid Waivers, also known as Home and Community-Based Services (HCBS) Waivers and 1915(c) Waivers, are the most popular. In recent years, the number of states that provide these waivers has risen dramatically, and aid may soon be accessible nationwide. However, other states are moving away from Medicaid waivers and toward a managed care approach. These states continue to provide the same benefits for assisted living, albeit through managed care programs rather than releases. A different sort of Medicaid program is called a State Plan Personal Care or Personal Assistance Services program. It is a standard Medicaid benefit (an entitlement, which means that anybody who qualifies for services can receive them) that covers personal care and allows recipients to receive it in assisted living communities.

States are increasing the help they provide to individuals living in assisted living facilities since they are cheaper than skilled nursing homes and thus less costly for the state. Medicaid’s benefits for assisted living are highly uneven. For instance, Medicaid in some areas covers solely personal care services in assisted living facilities. In some states, the community’s size is controlled. Some states limit the scope of assisted living facilities to tiny, adult foster care-type homes, while others restrict them to more significant households housing twelve or more people. Other states, on the other hand, have no restrictions on the number of residents. Another policy distinction is in the area of room and board. For example, some jurisdictions cap the amount of non-Medicaid assistance that can be invoiced or provided to Medicaid-eligible individuals.

A comprehensive list of states with Medicaid programs that assist with assisted living costs and associated qualifying conditions is accessible. Additionally, one can read more about Medicaid eligibility here.

Veterans’ Assisted Living Programs

Veterans can receive financial assistance for assisted living through a pension called the Aid and Attendance Benefit. As of 2021, this program can support single veterans up to $1,936 per month and married veterans up to $2,295 per month. Veterans who may be eligible for Medicaid and Aid and Attendance should check this comparison of the two programs.

Veterans may also choose the second option in independent living communities but not in assisted living communities. It’s worth mentioning that the term “independent living” has varying meanings in various states. The term “senior living community” refers to a facility that does not provide personal care or supportive services but may offer recreational activities and group meals.

Non-Medicaid State Programs

Numerous states have recognized that providing financial help to frail, elderly residents of assisted living facilities is less expensive for the state than placing them in a Medicaid-funded nursing home. It is frequently preferable for both the individual and their family. Regrettably, not all states offer these programs. However, each program helps to offset the cost of living in an assisted living community somehow. For instance, some of these programs provide cash assistance. It is not explicitly designated for assisted living but may be used for that purpose. Other programs offer supplemental benefits to participants who live in assisted living facilities rather than at home.

Medicare Original / Medicare Advantage

It is critical to dispel a widespread misconception about Medicare’s reimbursement of assisted living fees. Medicare does not subsidize the cost of assisted living, which includes room and board and personal care. However, Medicare may cover medical expenses incurred in an assisted living residence in the same way that it would cover medical costs incurred in a doctor’s office, hospital, or at one’s home.

On the other hand, Medicare Advantage (MA) may cover the cost of personal care assistance and other supportive services in assisted living facilities. Historically, Medicare Advantage plans did not have benefits primarily intended for “everyday maintenance.” According to MA plans in 2019 may provide “daily maintenance” benefits to those who live in an in-home environment. As if the services are medically necessary and recommended by a licensed clinician. In contrast, the CMS does not precisely define “in-home setting” as assisted living facilities qualify. Among the services that may be available under an MA plan (and apply to assisted living residents) are medical and non-medical transportation and assistance with daily living tasks like bathing, dressing, eating, laundry, and light housekeeping.

Assisted Living and Social Security

Social Security does not pay for assisted living in the strictest sense. However, they pay funds directly to individuals. However, state-specific Social Security programs can help families with the cost of assisted living in indirect ways. Typically, governments support beneficiaries by boosting or supplementing their Social Security benefits if they reside in an assisted living centre or an adult foster care home. It is a complicated and state-specific subject, so much so that it warrants a lengthy essay on its own.

Other Methods of Financing Assisted Living

Many Americans pay for assisted living out of pocket, utilizing a variety of options. The following sections examine each potential source and provide links to more extensive information.

Are You Aware?

Ninety-three per cent of assisted living residents are satisfied with their overall quality of life, level of independence, and level of personal attention from staff.

Reverse Mortgages & Home Equity Lines of Credit

Home equity lines of credit (HELOCs) are two ways for homeowners to use their homes to assist with assisted living costs. These solutions, however, are not available unilaterally to all homeowners, nor do they suit every family or a wise economic decision. For example, to qualify for a reverse mortgage, an individual must be married and reside in the home with their spouse. However, reverse mortgage guidelines require that the house be owner-occupied. Additionally, they have reduced associated fees. Or maybe a viable choice for mixed-age couples who are not eligible for a reverse mortgage.

Benefits and Conversions from Life Insurance

There are five distinct methods for using life insurance proceeds during a policyholder’s lifetime. However, not all five options are available to all policyholders, nor are they all economically viable. Life insurance is one of the least-used self-pay choices for assisted living.

Senior living. Using this strategy, it is likely that life insurance policyholders will receive the most value for their coverage among the five possibilities.

Creating an Assisted Living Financial Plan

Because many families pay for assisted living with their savings, so most aid programs judge an individual’s eligibility based on their resources. For this purpose (and others), it is prudent to prepare a long-term financial strategy when considering assisted living and how does assisted living work financially.

Developing a financial plan for assisted living is a complex procedure that must account for various health conditions. Fortunately, a range of services is available to assist families with financial planning for assisted living, and each resource has several advantages and disadvantages.

Counsellors for Public Benefits-Local agencies such as Area Agencies on Aging (AAA) and Aging and Disability Resource Centers (ADRC) frequently have benefits counsellors on staff. They assist families in understanding their financial alternatives for assisted care but do not operate as financial advisors. They are often well knowledgeable about local programs but may lack financial planning experience.

 Geriatric Care Managers – GCMs assist families in developing and implementing long-term care plans, and some also help with financial planning. Because GCMs often self-fund, clients can anticipate a higher level of attention than they would receive from a public benefits counsellor. 

Eldercare Resource Planners – ERPs are financial planners that specialize in assisted living. Because they often have a financial background rather than a healthcare background. As well they are substantially less expensive than elder law attorneys. But they cannot undertake some legal procedures that only attorneys can perform. Discover more.

Elderlaw Attorneys – Elderlaw attorneys are the most expensive and thorough alternative. In comparison, this attorney and their team can provide a one-stop shop for financial preparation for assisted care. But their hourly charge may be prohibitively expensive for some families. A disadvantage is that an elder law attorney may be unfamiliar with local aid programs for low-income households.


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